Symptoms and Diagnosis


In this section we’re going to take a look at:

Remember, everyone is different and your symptoms and experience may be different from that described below. If you have any further questions, be sure to ask your medical professional.

Symptoms

In the early stages, when the cells in the cervix are changing (but before they’ve become cancerous) you are unlikely to notice any symptoms. Women will often only start to notice symptoms once the cancer begins to grow into the tissues around the cervix. This can lead to the following symptoms:

  • Spotting or bleeding between periods
  • Bleeding or spotting after your periods have stopped (menopause)
  • Bleeding after sexual intercourse
  • Periods that are longer or heavier than they normally are.
  • Pain during or after sex
  • Pain in the area of your pelvis, lower abdomen or lower back

Many of these symptoms may have other causes, so it’s important to see your doctor if you experience any of these signs. It’s also important to enrol and participate in the national screening programme for cervical cancer.

A Diagnosis of Cervical Cancer

If you have regular smear tests, then most cases of early-stage cervical cancer will be picked up during screening before the onset of any symptoms.

If cell changes are picked up during screening when they are pre-cancerous then it’s likely that cervical cancer can be avoided altogether because these cells can be removed before they turn into cancer.

If the results of your smear shows the presence of abnormal cells, your doctor will recommend further tests. These could include:

  • A colposcopy: This is a procedure which gives the doctor a magnified view of the cervix. The doctor inserts a colposcope into the vagina in order to view a magnified image of the cervix so that he or she can examine the tissue and identify any abnormal areas.
  • Cervical biopsy: If an area of abnormal cells is found during the colposcopy, the doctor will remove a small sample of tissue for analysis. Sometimes the removal of tissue can be slightly painful.
  • A cone biopsy: This is performed if the results of the biopsy reveal the presence of pre-cancerous cells. It involves the removal of a larger cone-shaped piece of the cervix containing abnormal cells.
  • Imaging tests: These may be ordered to check whether the cancer has spread beyond the cervix to other organs near your cervix. They could include:
    • A CT scan
    • An MRI scan
    • A PET scan.

The Stages of Cervical Cancer


Pre-cancerous changes to the cervix are called cervical intraepithelial neoplasia or CIN. Depending on how abnormal or widespread the cells are they may be classified as:

Stage

Definition

CIN 1

A small amount of tissue looks abnormal. This is the least serious form of pre-cancer.

CIN 2

A moderate amount of tissue looks abnormal.

CIN 3

Most of the tissue looks abnormal. This is the most serious form of pre-cancer and includes carcinoma in situ.

If the results of your biopsy reveal the presence of cancer cells, then your doctor will determine what “stage” of cervical cancer you have.

The staging of cancer is simply a way of determining how far the cancer has spread. There are five stages of cervical cancer and these are:

Stage

Definition

Stage 0

The cancer affects only the cells on the surface of the cervix, and is not found any deeper. This stage is also called carcinoma in situ (CIS), which is a form of CIN3.

Stage I

The cancer has spread to the tissues of the cervix, but has not moved beyond the uterus or to nearby lymph nodes.

Stage II

The cancer has spread beyond the cervix and vagina, but has not yet spread to the walls of the pelvis or the lower part of the vagina.

Stage III

The cancer is found in the walls of the pelvis and the lower part of the vagina, and may be blocking the ureters (the tubes that carry urine to the bladder from the kidneys). It has not spread to nearby lymph nodes or other parts of the body.

Stage IV (Metastatic, advanced or secondary)

The cancer has spread to nearby organs and other parts of the body.

Your doctor will make treatment decisions based on the stage of cancer you have, the size and location of the tumour and your general health.